Intussusception- Most commonly around ileocaecal valve
- Loads of Peyers patches there
- Red-current jelly stools
- Pressure => venous obstruction => engorgement => blood loss
- Pain comes from compression of the serosa of the inside bit
- Pain fibres are in the serosa
- DON'T bother doing an AXR
- Much easier, quicker to see using US
- Use AIR rather than barium enemas
- Frequency 1/300 - 1/350
- Similar to pyloric stenosis
- Secondary causes
- Meckel diverticulum
- Cancer
- Commonly B cell lymphoma, in the bowel wall
- Cysts
- Polyps
Circumcision
- Absolute medical indications
- Phimosis secondary to balanitis xerotica obliterans
- Recurrent balanoposthitis
- Relative indications
- Paraphimosis
- Balanoposthitis and balanitis
- Preputial “pearls” and redundant foreskin
- Phimosis
- Prevention of sexually transmitted infections?
- Uncircumcised males are more prone to genital ulcer disease (syphilis, chancroid, herpes simplex) as well as infection with human papillomavirus
- But circumcised men were more prone to urethritis
- Prevention of HIV infection
- Prevention of penile cancer
- Prevention of urinary tract infection in boys with urological abnormalities
- Trauma
Notes
- 6 month old baby, obstruction?
- Strangulated inguinal hernia (very common)
- Intussesception
- Give vitamin K to neonates
- Otherwise they'll be bleedy up to about 8 days
- If a bowel loop is wider than the vertebrae, it's distended
- Triad of obstruction
- Abdominal distension
- Bilious vomiting
- Not pooing
- COMMONEST CAUSE OF OBSTRUCTION IS A STRANGULATED INGUINAL HERNIA!
- NEC is a common cause of obstruction in a neonate
- Posthitis is inflammation of the foreskin
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